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Dr. Deb
Dr. Deb, Animal Behaviorist
Category: Pet
Satisfied Customers: 9437
Experience:  I have been a practicing veterinarian for over 30 years.
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Our 16 year old cairn fell out of our bed the night before

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our 16 year old cairn fell out of our bed the night before last. I am not sure if it was because he was having a seizure or if he had the seizure because he fell. I carefully place him in a safe soft place. The seizure didn't last more than a minute. What is concerning is that he is not able to stand. He takes water, has a good appetite, he is engaging and watching the room activity, has bright eyes, perky ears and doesn't appear to be in any pain. He moves on his pillow, stretches his like and sits up but won't stand. I thought that he might have been very sore from the fall and muscle spasms and and that is why he was not standing but know I wonder if something else might be going on.
Submitted: 1 year ago.
Category: Pet
Expert:  Dr. Deb replied 1 year ago.

Hello, I'm Dr. Deb and will do my best to help you today.

I'm sorry for this concern for Sparky but share your worry that something else may be going on if he's not responding to pain and nsaid medication after his trauma.

I do have a few additional questions to ask about him first if you don't mind:

1. Can you take his temperature?

2. Are all four legs involved or only some of them?

3. If you pinch in between his toes really hard, what does he do?

4. I'm assuming that you can't localize any areas of pain or discomfort when you feel around on his body?

There may be a slight delay after I receive your answers since I have to type up a response to you. Thanks for your patience. Deb

Customer: replied 1 year ago.
I think temp is 98 degrees (rectal) I have never taken his a dog temp before so now sure if I put it in far enough. He pulls his feet away from my hands when I pinch between his toes. I haven't been able to find any painful areas when I manipulate or massage. He will put weight on all legs but if I let go he would fall over.
Customer: replied 1 year ago.
Sorry for the typos. didn't have my glasses on. Sparky is 16 yrs and 4 months. He did seem to be in pain right after the seizure so we didn't move for about 1 hour. After the hour with a heating paid and the gabapentin he allowed us to move him with out whining. He has not been interested in trying to stand since. This happened at 3:30 AM Friday morning.
Expert:  Dr. Deb replied 1 year ago.

Thanks for the additional information and answers to my questions.

I suspect you didn't insert the thermometer in quite far enough since this is a bit on the low side. Normal temps are 100-102.5 but at least we know it's probably not elevated.

When you pinch a dog's toes, they should retract or pull away since this is an involuntary reflex. The fact that he did so is a good thing.

It doesn't sound as if bruising or soreness would be the reason he can't support himself. Even if he did sustain some sort of soft tissue injury, I'd expect him to be walking although he might be quite stiff. Therefore, other possible explanations for his behavior include:

A problem with his spine where there's compression of his cord by either a disc or mass. It's certainly possible that his fall might have caused this problem although in many cases, there is no known event which can be identified. A thorough neurolgic exam is often enough to confirm this problem although sometimes spinal x-rays are suggested or additional testing such as an MRI is needed to confirm.

If this is the case, then the sooner Sparky is seen, the better. The longer the spinal cord is compressed, then the more severe the damage that might be done....which would be irreversible in some cases.
I'm not trying to alarm you but provide you with all of the information.

There are other possible causes such as Tick Paralysis or a condition called Discospondylitis which is an infection along the vertebrae but I'm not a huge fan of coincidence so these seem less likely to be the problem.

You're not going to be able to increase his Meloxidyl but you could possibly increase his Gabapentin dose if I know how much he weighs.

He might also need muscle relaxers which would have to be dispensed by a vet (which you probably already know).

If the fall had happened within or less than 24 hours ago, then I might advise giving him more time to see if he would come around but I'm a little concerned that so much time has passed and he's not willing to stand.

A vet visit might be prudent if at all possible but if you want to increase his Gabapentin dose, please let me now how much he weighs. Deb

Customer: replied 1 year ago.
Thank you for your thorough answer. He weighs 16 lbs and the capsules are 100 mg. Is there a position that would be best for him until we can get him to the vet?
Expert:  Dr. Deb replied 1 year ago.

You're more than welcome.

There's a range with Gabapentin and if he's been on it for a while, then he may have become a little resistant to his current dosage (which is what I would have initially prescribed for a dog this weight). But it can be increased to 150 mg up to 3 times a day. I don't know if I'd increase it by that much but perhaps 150 mg in the am and pm but only 100 mg mid day, if that makes sense.

There probably isn't one position that's going to be superior to another if he's at least sitting up (which I would encourage) and not constantly laying on his side. He'll assume the position that's most comfortable for him.

Deb

Customer: replied 1 year ago.
He can sit up so we will encourage that. Is holding him up while in our lap okay? I am worried that it is the compressed spinal cord. At his wellness check this summer the vet suggested that he was loosing strength in his back legs and cited the possibility that this was happening at that time. She also said that he wasn't in any pain and was otherwise very healthy. Thank you for the dosage adjustment.
Expert:  Dr. Deb replied 1 year ago.

I think holding him in your lap would not only be comforting for you both but wouldn't cause any additional harm.

If this has been something of a chronic problem, then the trauma may have exacerbated this pre-existing condition...which does make some sense to me.

I agree that he's not likely to be in a significant amount of pain right now if he's not vocalizing but increasing his dose shouldn't be harmful and may help if he is.

Even in the worst case scenario (which is that he can't support himself), if his front legs are reasonably strong, then you might consider a wheelchair for him. I do understand that individual circumstances may prevent this from being an option but I've seen a number of dogs with spinal issues do phenomenally well in them. Deb

Customer: replied 1 year ago.
Thank you very much. We do already have a wheel chair for him which he is starting to appreciate. We just gave him 100 mg at 1:30 so we will wait now until we get to the vet . We are on our way to the emergency vet now. Thank you again for helping us figure this out. We really appreciate this great resource!
Expert:  Dr. Deb replied 1 year ago.

Sorry that I had to step away from my computer and have just now seen your last reply.

You're more than welcome; I'm glad that I could help and that you're happy with the site and service.

I do hope that you'll keep me posted after your ER visit; I'd very much like to know what the vets there think about him. Even after you've rated (if you do, of course), we can continue to communicate about this issue at no additional charge to you.

Best of luck with him. Kind regards, Deb

Customer: replied 1 year ago.
Hi - after a visit to the emergency vet - we are hoping that Sparky has some swelling in his head that needs some time to heal and that is what caused the seizure (after the fall) We had some blood drawn to eliminate some other reasons for his seizure. The doctor does not think his issue has anything to do with his spine, He did mention that a brain tumor could be the cause of his seizures. He prescribed presnione to begin on Monday - was unclear of the medication to reduce swelling or cancer treatment. We are praying that Sparky in a short time will return to his active self.
Expert:  Dr. Deb replied 1 year ago.

Thanks for the update on Sparky.

If his seizures started when he was older (and isn't a problem he's had for a while), then a brain mass is, unfortunately, the most common cause for them in senior patients. These masses do tend to be slow growing but are space occupying lesions in the brain, after all. It typically takes an MRI to diagnose them but they aren't usually located in areas of the brain where surgery is either practical or advisable but I suspect this is something you already know. And, chemo isn't typically prescribed for these patients although I know some vets do use steroids.

If I suspect this condition, then I'll usually start my patients on anti-seizure medication which can help reduce the frequency and severity (in some cases), at least for a while anyway.

I always run blood work as your ER vet did to ensure that liver issues or other metabolic conditions aren't present.

Pred is not a bad choice of drug since it could be helpful whether there's a central lesion present (brain mass or swelling) or a more localized one (spinal issue--even though the vet didn't think this was the problem).

So, regardless, it's a good drug for him to be taking.

Continued best wishes for him and please continue to keep me posted if you have the time. Deb

Dr. Deb and 2 other Pet Specialists are ready to help you
Expert:  Dr. Deb replied 1 year ago.
Hi,
I'm just following up on our conversation about Sparky. How is everything going?
Dr. Deb
Customer: replied 1 year ago.
We went to his regular vet on Monday. She feels like it is a mass/tumor in his neck that is preventing his brain from communicating with his legs. He has feeling and movement in all legs and no pain. She doesn't think he had a stroke and doesn't think it is a brain tumor at this time because of his current symptoms. We did not start him on the prednisone but are keeping him on the meds he has been taking. She is not certain that the condition will correct itself. We had a wheelchair that we ordered front wheels for as she is suggesting to keep his legs active. Thank you for following up!
Expert:  Dr. Deb replied 1 year ago.

I appreciate your taking the time to get back to me about him.

I suppose without a CT scan or MRI, we can't really know for sure what's going on but your current plan makes sense to me.

I would have been somewhat curious to know if the steroids might have helped although I understand why your vet might think it wasn't the prudent thing to do.

It doesn't sound as if his quality of life is necessarily adversely affected though; I'm glad that you're sticking with him:) Deb